For school nurses, navigating the ever-evolving landscape of attention-deficit/hyperactivity disorder (ADHD) medications is no small feat. From extended-release stimulants that promise all-day coverage to novel non-stimulant options that offer alternative pathways to symptom management, the toolkit for treating ADHD has never been more diverse – or more nuanced. These developments have expanded the toolkit available to healthcare providers and profoundly impacted the well-being of students with ADHD. Still, they also present new challenges in medication management within the school environment. 

ADHD medications are not a cure. But they help manage symptoms such as impulsivity, hyperactivity, and inattention. Stimulant medications, like methylphenidate (brand names include Ritalin, Concerta, Focalin, Daytrana), and amphetamines (e.g., Adderall, Dexedrine, Vyvanse) are commonly prescribed and work by increasing dopamine levels in the brain, which improves focus and behavior. Stimulant medications come in both short-acting (immediate-release) forms, which last about 3-6 hours, and long-acting (extended-release) forms, which last 6-12 hours or longer. Non-stimulant medications are often used when traditional stimulant treatments prove ineffective or produce unwanted adverse reactions. Non-stimulant medications may take several weeks before a noticeable benefit is achieved. 

ADHD treatment is not a one-size-fits-all approach. The effectiveness of medications can vary significantly among individuals, making personalized treatment essential. Each student's brain chemistry is unique, leading to different reactions to medications. 

School nurses are vital to supporting kids with ADHD. Well-positioned to share observations and insights that improve outcomes, school nurses are a crucial communication bridge between parents, teachers, and external healthcare providers and specialists. They are the cornerstone of effective ADHD medication management in the school setting. Practical considerations for school nurses include:

• Developing an Individual Health Plan (IHP) that outlines specific needs, emergency procedures, and routine medication administration.
• Ensuring safe medication administration practices, including meticulous record-keeping, secure storage of medications, and adherence to prescribed schedules. Parents should be encouraged to consider their student's after-school activities when determining the medication schedule.
• Observing for common side effects of ADHD medications, such as decreased appetite, sleep problems, mood changes, and tics, as well as changes in behavior that may be medication-related.
• Fostering an inclusive environment that supports the learning and well-being of students with ADHD, reducing stigma, improving medication adherence, and helping students thrive both academically and socially.

ADHD is not just a classroom challenge. ADHD is chronic in nature and can affect students' self-esteem, relationships, and their future. By acting as the essential link between prescription and performance for students with ADHD, school nurses can be champions of neurodiversity, helping to unlock the full potential of students with ADHD, and transforming classrooms into environments where every mind can flourish.